| NPI | 1477789865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IL 180.006198) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 12956) |
| Enumeration Date | 2009-05-31 |
| Last Update Date | 2017-02-25 |